Technical Evaluation of Trabecular Metal Augments and Custom Implants in Severe Acetabular Bone Deficiencies

Master thesis (2022)

Authors

J.I. Barends Mechanical Engineering

Contributors

Bart Kaptein Leiden University Medical Center (supervisor 1)
Rob Nelissen Leiden University Medical Center (supervisor 1)
Demien Broekhuis Leiden University Medical Center (supervisor 1)
Eveline Corten Erasmus MC (supervisor 2)
J. Harlaar Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering (supervisor 2)
Faculty
Mechanical Engineering
Copyright: © 2022 Jessica Barends
Revision total hip arthroplasty Trabecular metal Custom-design implants Severe bone defect Pelvic discontinuity
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Published Date

31-10-2022

Language

English

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Faculty

Mechanical Engineering

Abstract

Introduction: Revision total hip arthroplasty (THA) can be challenging in patients with severe acetabular bone defects and there is no consensus on the preferred reconstruction technique in this population. The aim of this study is to determine the biomechanical differences between Trabecular Metal Acetabular Revision System (TMARS) and Custom Triflange Acetabular Component (CTAC), in patients with Paprosky grade IIIB acetabular bone defects.
Methods: A retrospective study with patients undergoing revision THA surgery TMARS was conducted. For all these patients a virtual CTAC was designed. With this, the TMARS reconstruction could be compared with the virtual CTAC. Assessments of both implants included cortical and cancellous bone contact, center of rotation (COR), inclination, anteversion, and reamed bone volume.
Results: The mean bone contact was 5760 mm2 vs 5447 mm2 for TMARS and CTAC respectively. The TMARS showed significantly more cancellous bone contact than the CTAC (4966 mm2 vs 2887 mm2) and less cortical contact (795 mm2 vs 2560 mm2). The TMARS COR was significantly deviated in the medial-lateral direction compared to the CTAC, with a mean difference of 7.4 mm in lateral direction. TMARS showed a significantly greater reamed bone volume with a mean of 15997 mm3 for TMARS and 2292 mm3 for CTAC.
Conclusion: A semi-automatic method was designed for the determination of the biomechanical differences between TMARS and CTAC reconstructions. TMARS showed significant more cancellous bone contact, but also significant greater reamed bone volume with respect to CTAC. Furthermore, the TMARS COR was localized significantly more lateral compared to CTAC.